title: Diagnostic efficacy of PET and PET/CT for recurrent lung cancer: a meta-analysis.
abstract: BACKGROUND
  Lung cancer is one of the most common malignant tumors in the world, and is the leading cause of cancer-related mortality. Although there are no conclusive data to support the survival benefits of early detection or early treatment for recurrence, an early and accurate diagnosis of recurrence is critical to optimize therapy.
  
  
  OBJECTIVE
  To compare the diagnostic value of positron emission tomography (PET) and positron emission tomography/computed tomography (PET/CT) using fluorine-18 deoxyglucose (18FDG) with conventional imaging techniques (CITs) for the detection of lung cancer recurrence.
  
  
  METHODS
  A meta-analysis was performed, with systematic searches conducted using PubMed and EMBASE databases (up to 31 December 2011). Pooled sensitivity, specificity, and diagnostic odds ratio (DOR) values were calculated for 1035 patients reported in 13 articles. Summary receiver-operating characteristic curves (SROC) were also generated.
  
  
  RESULTS
  The pooled sensitivity (95% CI) for PET, PET/CT, and CITs were 0.94 (0.91-0.97), 0.90 (0.84-0.95), and 0.78 (0.71-0.84), respectively. The pooled specificity (95% CI) for PET, PET/CT, and CITs were 0.84 (0.77-0.89), 0.90 (0.87-0.93), and 0.80 (0.75-0.84), respectively. Regarding sensitivity, lower values were associated with CITs than PET (P = 0.000) and PET/CT (P = 0.005), and there was no significant difference between PET/CT and PET (P = 0.102). Regarding specificity, values for PET/CT and PET were significantly higher than for CITs (both P = 0.000), and there was no significant difference between PET/CT and PET (P = 0.273). In the SROC curves, a better diagnostic accuracy was associated with PET/CT than PET and CITs.
  
  
  CONCLUSIONS
  PET/CT and PET were found to be superior modalities for the detection of recurrent lung cancer, and PET/CT was superior to PET.
authors.affiliation: Department of Respiratory Medicine, West China Hospital of Sichuan University, Chengdu, PR China.
authors.forename: Yan-Qi
authors.initials: YQ
authors.lastname: He
authors.forename: Han-Lin
authors.initials: HL
authors.lastname: Gong
authors.forename: Yi-Fu
authors.initials: YF
authors.lastname: Deng
authors.forename: Wei-Min
authors.initials: WM
authors.lastname: Li
mesh_terms: D003287:Contrast Media; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging*; D064847:Multimodal Imaging; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging*; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed
chemical_list: D003287:Contrast Media; D019275:Radiopharmaceuticals
keywords: PET; diagnosis; integrated PET/CT; lung cancer; meta-analysis; recurrence